Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2024 Nov;171(5):1355-1361. doi: 10.1002/ohn.936. Epub 2024 Aug 15.
To compare the prevalence of mental health disorders in individuals with facial synkinesis, facial paralysis alone, and the general population.
Retrospective cohort.
Eighty-two health care organizations across the United States.
The TriNetX Research Network was queried from 2011 to 2021 for patients with facial paralysis without synkinesis, facial paralysis and documented synkinesis, and controls, matched for age, sex, race, and ethnicity. Cases included infectious, iatrogenic, or idiopathic facial paralysis. Patients with pre-existing depression or anxiety were excluded. Two-year rates of newly diagnosed depression, anxiety, and mental health prescriptions were compared.
Among 127,573 patients with facial paralysis, 92.5% (n = 117,976) had facial paralysis alone, and 7.5% (n = 9597) also had documented synkinesis. Compared to controls, patients with facial paralysis alone had increased risks of new depression (8.9% vs 7.3%, P < .001) and anxiety (10.1% vs 9.6%, P < .001), with higher mental health medication rates (16.6% vs 13.1%, P < .001). Patients with documented synkinesis, in comparison to controls, had the highest risks of depression (19.8% vs 8.6%, P < .001), anxiety (20.5% vs 10.5%, P < .001), and prescriptions (28.1% vs 15.8%, P < .001). The 27.8% (n = 2669) of synkinetic patients treated with chemodenervation had lower rates of depression (8.5% vs 23.5%, P < .001), anxiety (9.0% vs 23.8%, P < .001), and prescriptions (21.6% vs 30.0%, P < .001) compared to synkinetic patients who were not.
Facial paralysis, particularly synkinesis, is linked to increased mental health disorders. Integrating mental health screening and treatment into a comprehensive approach is crucial. Chemodenervation is associated with decreased mental health disorders in synkinesis, highlighting its therapeutic potential.
比较面肌联带运动患者、单纯面瘫患者和普通人群中心理健康障碍的患病率。
回顾性队列研究。
美国 82 家医疗保健机构。
从 2011 年至 2021 年，TriNetX 研究网络对无面肌联带运动的单纯面瘫患者、有面肌联带运动且有记录的面瘫患者和对照组进行了查询，对照组在年龄、性别、种族和民族方面与之匹配。病例包括感染性、医源性或特发性面瘫。排除了有预先存在的抑郁或焦虑的患者。比较了新诊断的抑郁、焦虑和精神健康处方的两年发生率。
在 127573 例面瘫患者中，92.5%（n=117976）为单纯面瘫，7.5%（n=9597）还存在有记录的面肌联带运动。与对照组相比，单纯面瘫患者新发抑郁的风险增加（8.9% vs 7.3%，P<0.001）和焦虑（10.1% vs 9.6%，P<0.001），精神健康药物使用率更高（16.6% vs 13.1%，P<0.001）。与对照组相比，有记录的面肌联带运动的患者抑郁（19.8% vs 8.6%，P<0.001）、焦虑（20.5% vs 10.5%，P<0.001）和处方（28.1% vs 15.8%，P<0.001）的风险最高。27.8%（n=2669）接受化学神经切断术治疗的联带运动患者的抑郁发生率较低（8.5% vs 23.5%，P<0.001）、焦虑（9.0% vs 23.8%，P<0.001）和处方（21.6% vs 30.0%，P<0.001）。
面瘫，特别是面肌联带运动，与心理健康障碍的增加有关。将心理健康筛查和治疗纳入综合治疗方法至关重要。化学神经切断术与面肌联带运动中的心理健康障碍减少相关，突出了其治疗潜力。
